- Placental factors Causing IUGR.

 Placental factors Causing Intrauterine Growth
Restriction

· Placental insufficiency due to maternal disorders, such as pre-eclampsia and eclampsia, or due to post-term gestation.

Ü Presence of asymmetrically grown fetus, low amniotic fluid index, and umbilical artery abnormalities (abnormal waveforms, absent or reversed end-diastolic flows) together suggests placental insufficiency.

·     Gross cord and placental abnormalities:

–       Single umbilical artery.

–       Abnormal umbilical vascular insertions (marginal cord insertion, circumvallate, velamentous).

–       bilobed placenta

–       circumvallate placenta.

–       multiple infarcts

–       umbilical vascular thrombosis and hemangiomas.

–       Infectious villitis (as with TORCH infections)

·     Placental mesenchymal dysplasia is a rare placental abnormality characterized by placentomegaly and grape-like vesicles resembling a partial mole. The euploid fetus with these findings is at increased risk for FGR, perinatal death, and Beckwith-Wiedemann syndrome.

·     Multiple gestations may be associated with significant placental problems such as abnormal vascular anastomoses and inability of the uteroplacental environment to meet the nutritional needs of multiple fetuses.

·     Abruption (chronic, partial).

·     Placenta previa